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Background: The ultimate goal of advanced procedures in prosthetic dentistry is to construct a prosthesis based on the accurate reproduction of condylar guidance. Aim: To compare the sagittal condylar inclination obtained using the cone-beam computed tomography (CBCT), panoramic image, and two articulator systems. Settings and Design: A cross-sectional study was carried out in 20 dentate patients in the age group of 20–40 years. Materials and Methods: Sagittal condylar guidance angles (SCGAs) were measured on two semi-adjustable articulators (Hanau Wide Vue and Denar Mark 320) using protrusive interocclusal record. SCGAs were also measured on the CBCT scans (CBCT reconstructed panoramic image and CBCT sagittal cross section) and the panoramic images obtained from the patients. The angles were determined on the radiographs by joining two lines: Frankfort’s horizontal plane and the other plane were drawn by connecting the superior-most point on the glenoid fossa and the inferior-most point on the articular eminence. All the measurements were done twice by two operators independently. Statistical Analysis Used: The data were analyzed using the paired t-test and Pearson’s correlation coefficient with a P ≤ 0.05. Results: There was no significant difference between the right and the left side in any of the groups (P ≥ 0.05). In addition, there was no significant difference between the clinical methods (P ≥ 0.05). However, there was a significant difference between the clinical and the radiographic methods (P ≤ 0.05). Furthermore, there was a strong correlation between the clinical and radiographic methods with Pearson’s Correlation coefficient above 0.67. Conclusion: There is a strong correlation between the clinical and radiographic methods. Thus, CBCT and OPG can be used an adjunct to clinical methods to record sagittal condylar guidance.

“Brown tumors (BTs)” of the spine are benign rare lesions, seen in about 5%–13% of all patients with chronic hyperparathyroidism (HPT). They are not true neoplasms and are also known as osteitis fibrosa cystica or occasionally osteoclastoma. Radiological presentations are often misleading and may mimic other common lesions such as metastasis. A strong clinical suspicion is therefore necessary, especially in the background of chronic kidney disease with HPT and parathyroid adenoma. Surgical spinal fixation in case of instability due to pathological fracture may be required along with excision of the parathyroid adenoma being the treatment of choice, that maybe usually curative and carries a good prognosis. We would like to report one such rare case of BT involving the axis, or C2 vertebra, presenting with neck pain and weakness that was treated surgically. Only a few cases of spinal BTs have been reported so far in the literature. Involvement of cervical vertebrae and in particular C2 is rarer still with the one in this report only being the fourth such case.

Objective: This study evaluated the effect of chemical disinfection and microwave irradiation on the surface hardness and roughness of two commercially available hard relining materials (Ufi Gel hard, GC Kooliner) and one denture base resin (Trevalon). Materials and Methods: A total of 72 specimens (n = 24) were divided into four groups. C: Not disinfected, Cl: disinfected with 4% chlorhexidine solution, Gl: disinfected with 2% glutaraldehyde solution, Mw: disinfected with microwave irradiation (650 W; 6 min). Hardness and roughness measurements were made after polymerisation, 1st day, 14th day and 28th day. Results: Ufi Gel hard showed an increased roughness after 1st day (P = 0.021) following chemical disinfection and GC Kooliner showed similar results after 14th day (P < 0.05). Microwave irradiation showed a significant increase in surface roughness value after 1st day (P < 0.05) for both Ufi Gel hard and GC Kooliner. Hardness of both Ufi Gel (12.131 to 7.333 VHN) and Kooliner (9.133 to 5.276 VHN) was significantly reduced by chemical disinfection, while microwave irradiation resulted in an increased surface hardness of Kooliner (from 9.126 to 12.713 VHN) and Ufi Gel hard (from 11.698 to 14.940VHN). Results for Trevalon were not significant for both the disinfection methods. Conclusions: Microwave irradiation increased the surface roughness and hardness of Ufi Gel hard and Kooliner, while chemical disinfection resulted in a decreased hardness and increased roughness of both hard relining materials. There was no effect of either of the disinfection methods on Trevalon.

Purpose: Childhood blindness is second to cataract in terms of blind person years; population-based prevalence of ocular morbidity among tribal children has not been studied. We conducted this study to determine the prevalence of ocular morbidity in tribal children age 15 years or younger in Jawadhi hills, southern India. Methods: A population-based cross-sectional study was conducted in four tribal villages where all children below 15 years of age were invited to participate in the study. After appropriate consent/assent, an optometrist assessed uncorrected vision refraction and best-corrected visual acuity using suitable techniques. A comprehensive ophthalmic examination was also done by an ophthalmologist to determine the presence of ocular morbidity. Children requiring cycloplegic refraction or further treatment were referred to the base hospital. Results: Among 260 children examined, the prevalence of ocular morbidity was 10.8% [95% confidence interval (CI): 6.3–13.7]. Vitamin A deficiency (VAD) was the foremost morbidity: 4.6% (95% CI 1.6–6.3) followed by refractive error (2.7%). Three (10.7%) children had more than one ocular morbidity. Nearly 1 in 10 tribal children suffer from ocular morbidity and 1 in 57 had low vision. Conclusion: VAD is a public health problem in this tribal region which requires immediate intervention with prophylaxis and treatment. Uncorrected refractive errors in school-age children also need to be attended.

Objective: To assess the occurrence of diabetes in obese nondiabetic patients over a 3-year follow-up period with a correlative analysis of visceral fat (VF), fasting insulin levels, (FILs) and insulin resistance (IR). Material and Methods: Thirty-seven obese and nineteen nonobese nondiabetics of our previous study, Mysore Visceral Adiposity in Diabetes were followed for the next 3 years. Their blood pressure, body mass index, waist circumference (WC), fasting blood sugar (FBS), FIL, lipid profile and subcutaneous fat (SCF), and VF measurement by US method were repeated every 6 months for the next 3 years. The findings were analyzed with appropriate statistical methods. Results: Twenty-three obese and 18 nonobese nondiabetics completed the study. There were 17 dropouts. The changes in the physical and biochemical characteristics of the two groups before and after the study were not significant. SCF had no correlation with IR whereas VF correlated with FIL and IR. There were three diabetics in the obese group and two from the control group at the end of the study. There were 12 impaired glucose tolerance (IGT) in the test group and 2 in the control group. Those who developed diabetes had higher VF, WC, FBS, FIL, and IR. Those who showed IGT also had these at higher levels compared to others. There was no change in the VF at the end of the study. Conclusions: This follow-up study on South Indians has shown that VF is a significant risk factor for the development of IR. IR can develop without any increase in the volume of the VF, is the essential finding of this study. SCF has not shown any significant relationship with IR. We recommend FBS and FIL in all the obese nondiabetics to calculate IR, which has given much insight in the development of IGT and diabetes. Large multicentric, longitudinal studies are required to establish the cause of IR.

In addition to the well-known complications such as neuropathy, nephropathy, retinopathy, diabetes mellitus can also result in a variety of rheumatologic manifestations, some of which can significantly affect a patient's quality of life. Diabetic cheiroarthropathy (DCA), which affects the hands clinically, manifests as painless limited extension of the proximal metacarpophalangeal joints and/or interphalangeal joints with spontaneous flexion of the fingers. There is decreased ability to fully flex or fully extend the fingers. This is the so-called “Namaste” or “Prayer” sign. This sign gives an indication of metabolic control of diabetes and microvascular disease. We hereby report a middle-age male patient admitted for fever and was incidentally found positive for this sign. Fundoscopy revealed nonproliferative diabetic retinopathy and there was microalbuminuria. The diagnosis is mainly clinical. It is imperative for clinicians to remember that the presence of DCA carries with it a significant relationship with microvasculopathy.

Objective: To measure the levels of proinflammatory cytokines tumor necrosis factor-alpha (TNF-α), interleukin-6(IL-6), and high-sensitive C-reactive protein (hs-CRP) and the anti-inflammatory cytokine adiponectin (AN) in obese South Indian subjects and to ascertain whether or not a causal role could be ascribed to these cytokines in the development of insulin resistance (IR). Materials and Methods: Forty obese and forty nonobese volunteers of both genders were recruited. Parameters such as body mass index (BMI), waist circumference (WC), and blood pressure were evaluated. Fasting blood sugar (FBS), fasting insulin level, hemoglobin A1c (HbA1C), lipid profile, TNF-α, IL-6, hs-CRP, and AN levels were measured. IR was evaluated by homeostatic model assessment-IR method. Abdominal adiposity was measured by ultrasonography. The results were statistically evaluated by appropriate tests. Results: BMI, WC, and visceral fat were high in the obese group. Females had higher subcutaneous fat in both groups. HbA1C was marginally high in the obese group ( P = 0.014). IR was high in all the groups, obese males showing higher values (not significant[NS]). Total cholesterol and low-density lipoprotein were high in the obese group ( P = 0.028, P = 0.003). TNF-α was high in obese males (NS), IL-6 was high in both groups, higher in nonobese females (NS), hs-CRP was high in both groups, higher in females of both groups (NS). AN was high in females of both groups ( P = 0.002). Conclusions: In this study on South Indian subjects, proinflammatory cytokines such as IL-6 and hs-CRP, despite being high, did not show any causal correlation either with abdominal obesity or with IR. TNF-α being normal showed some correlation which was inconsistent. Even the anti-inflammatory adipokine, AN did not show any correlation with IR. Cytokines had an inconsistent correlation with the components of metabolic syndrome hence were not useful.

Aim: To evaluate the changes in surface topography and roughness of stainless steel (SS), nickel-titanium and beta-titanium (β-Ti) archwires after clinical use and sterilization. Settings and Design: Thirty wires each of SS, nitinol, and β-Ti (3M Unitek) were tested in as received, as received and autoclaved, and clinically retrieved then autoclaved conditions. Materials and Methods: A sterilization protocol of 134°C for 18 min was performed using an autoclave. Surface topography of specimens from each subgroup was examined using an environmental scanning electron microscope (ESEM model Quanta 200, The Netherlands) at ×100, ×1000, and ×2500 magnifications. Surface roughness was measured using arithmetic mean roughness (Ra) values obtained from optical profilometric scanning (Taylor Hobson, Leicester, UK). Statistical Analysis: Data were analyzed by one-way analysis of variance and Tukey's post-hoc procedures. Results: Scanning electron microscope images revealed an increase in surface irregularities in SS and nitinol wires after clinical use. There was a significant increase in Ra values of SS orthodontic wires after intra-oral exposure (P = 0.0002). Conclusion: Surface roughness of SS wires increased significantly after clinical use. Autoclave sterilization did not affect considerably on surface characteristics of any archwire.

Background: Medullary thyroid carcinoma (MTC) is a tumor arising from the para follicular (C) cells of the thyroid gland and can occur either sporadically or as part of an inherited syndrome. A proportion of these cases carry an autosomal dominant mutation in the RET (REarranged during Transfection) proto-oncogene. Screening for these mutations in the affected patients and the carriers ′′at risk′′ which includes the first-degree relatives is of utmost importance for early detection and prompt treatment including prophylactic thyroidectomy in cases that harbor these mutations. Results: This report presents details of screening and subsequent follow-up of a large Indian family, where the index case was found to carry p.Cys634Ser mutation involving exon 11 of the RET gene. These data are of value considering the paucity of information within the region in context of screening large families affected by these mutations.

Digital clubbing is an ancient and important clinical signs in medicine. Although clubbed fingers are mostly asymptomatic, it often predicts the presence of some dreaded underlying diseases. Its exact pathogenesis is not known, but platelet-derived growth factor and vascular endothelial growth factor are recently incriminated in its causation. The association of digital clubbing with various disease processes and its clinical implications are discussed in this review.

Introduction: There is a need to reassess the significance of myoedema in evaluation of overt hypothyroidism in the current day clinical practice. It is commonly checked for by flicking across the biceps belly expecting a transient mound at the points of tactile stimuli with mild pressure. Aim and Objective: To assess elicitation of myoedema in overt hypothyroidism (defined arbitrarily as TSH >50 mIU/L in primary hypothyroidism and fT4 150 mIU/L. Myoedema was elicited in 8 of 13 in the severe OH group, in 2 of 7 in moderate OH group and in 1 of 8 in the mild OH group. In the group of secondary hypothyroidism, myoedema was elicitable in one of two patients. The odds ratio for presence of both myoedema and clinical features of myopathy in a group of overt hypothyroid patients with TSH >150 mIU/L as compared to